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Nation’s physician workforce evolves: more women, a bit older, and toward different specialties

Patrick Boyle, Senior Staff Writer
February 2, 2021

Women doctors remain concentrated in family and child specialties, while sports medicine is among the specialties that are growing, says a new data report from the AAMC.

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More women are becoming doctors, more doctors are nearing retirement age, and sports medicine is growing faster than any other specialty, according to a data report about the nation’s physicians released by the AAMC.

Internal medicine, family medicine, and pediatrics remain the most popular specialties, while pulmonary disease is losing specialists at the highest rate.

These are among the findings in the 2020 Physician Specialty Data Report, which highlights the numbers of physicians, residents, and fellows among 47 of the largest specialties in 2019. The AAMC has produced the report every two years since 2008. Here are some of the notable trends revealed by the 2019 data, which were collected before the COVID-19 pandemic:

Women’s steady rise

One of the steadiest movements has been the rise in women as a percentage of the physician workforce: It rose from 28.3% in 2007 to 36.3% last year, according to the AAMC’s Physician Specialty Data Reports from 2008 to 2020:

  • 2007 — 28.3%
  • 2010 — 30.4%
  • 2013 — 32.6%
  • 2015 — 34.0%
  • 2017 — 35.2%
  • 2019 — 36.3%

The growth in female physicians is the result of a steady increase in the number of female medical students. The AAMC’s annual report on medical school enrollment showed that 2019 marked the first time that the majority of U.S. medical school students (50.5%) were women. As the increasing numbers of female medical students graduate, the percentage of female physicians in the workforce should rise even more.

While that growth helps to make the field of physicians more diverse, women remain concentrated in some specialties and barely visible in others.

“We have a good deal more work to do in terms of gender equity,” says Michael Dill, the AAMC’s director of workforce studies. “If the majority of female physicians are still concentrated in a handful of specialties, then we haven’t gotten where we need to be.”

The specialties with the highest percentages of women are primarily focused on children and women, including:

  • Pediatrics — 64.3%
  • Obstetrics and gynecology — 58.9%
  • Child and adolescent psychiatry — 54.0%
  • Neonatal-perinatal medicine — 52.8%

Meanwhile, women remain a significant minority in such specialties as urology (9.5%), pulmonary disease (12.3%), and surgical specialties from general surgery (22%) to orthopedic surgery (5.8%).

Growth and decline

Some specialties have shown “remarkable growth” since 2014, the report says. In first place is sports medicine, which grew by 55.3%, while the separate specialty of orthopedic surgery within sports medicine increased by 39.8%.

Dill notes that those and several other large increases occurred in specialties that remain small in total numbers. For example, 2,897 doctors specialized in sports medicine in 2019, while emergency medicine — which grew by 17.2% — had 45,202 doctors.

Specialty preferences

Following are the percent changes in physicians within selected specialties, 2014-19:

  • Pediatric anesthesiology — up 52.8%
  • Critical care medicine — up 38.3%
  • Internal medicine — up 5.5%
  • Family medicine/General practice: up 5.3%
  • General surgery — 0%
  • Anatomic/Clinical pathology — down 7.0%
  • Pulmonary disease — down 10.6%

Aging doctors

“The physician workforce is aging,” Dill says.

Last year, 44.9% of physicians were age 55 or older — up from 44.1% in 2017 and 37.6% in 2007. The growing number of physicians nearing retirement age is one factor behind a projected physician shortage, which the AAMC has said needs to be addressed by increasing the capacity of the nation’s graduate medical education system.

As with gender distribution, age distribution varies significantly across specialties:

  • Doctors in the 55-and-above age group range from a high of 91.3% in pulmonary disease — the specialty that has been shrinking the most in recent years — to a low of 8.3% in sports medicine — the specialty that is growing the most.
  • Several of the specialties with the greatest percentage of older doctors, such as surgery specialties, also have among the highest percentages of male doctors.
  • Conversely, several of those with the lowest percentage of older doctors also have among the highest percentages of female doctors.

Specialties among older physicians

Following are the percentages of physicians age 55 and older within selected specialties, 2019:

  • Preventive medicine — 69.6%
  • Thoracic surgery 60.1%
  • Orthopedic surgery 57.1%
  • Urology 50.5%
  • Pediatrics — 44.5%
  • Pediatric critical care medicine — 23.3%
  • Pediatric anesthesiology — 8.9%

Residents and fellows

The specialty trends for residents and fellows somewhat mirror the trends among physicians, with some exceptions. The data are for residents and fellows in programs accredited by the Accreditation Council for Graduate Medical Education (ACGME).

  • The specialties with the largest numbers of first-year residents and fellows were the primary care specialties of internal medicine (10,379), family medicine/general practice (4,456), and pediatrics (2,993).
  • 45.8% of the residents and fellows in ACGME-accredited programs were women. Percentages of women in the 47 top specialties ranged from a high of 83.8% in obstetrics and gynecology residencies to a low of 12.9% in sports medicine (orthopedic surgery) residencies.
  • Between 2014 and 2019, first-year residents and fellows increasingly specialized in sports medicine (up by 29.1%) and neurology (25.2%), while large decreases occurred in ophthalmology (down 10.9%), plastic surgery (10.8%), and vascular and interventional radiology (10.5%).

For more details, including tables, read the full report.

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